Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Parental Anticoagulation in Non-ST Elevation Acute Coronary Syndromes: enoxaparin vs fondaparinux
Session:
Painel 6 - Doença Coronária 7
Speaker:
Pedro M. Lopes
Congress:
CPC 2020
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.4 Acute Coronary Syndromes – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Pedro M. Lopes; José Pedro Sousa; Pedro Oliveira De Azevedo; Rui Baptista; Cristina Gavina; Sílvia Monteiro; on behalf of the ProACS Investigators
Abstract
<p><strong>Background: </strong>According to the 2015 ESC Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) guidelines, fondaparinux is the parenteral anticoagulant with the most favorable efficacy–safety profile and is recommended over enoxaparin. Although, its use in a contemporary Portuguese cohort is not clear. The aim of this study was to assess the fondaparinux utilization rate and to compare its in-hospital efficacy and safety profile versus enoxaparin, in a contemporary Portuguese cohort of NSTE-ACS.</p> <p> </p> <p><strong>Methods: </strong>Patients admitted with NSTE-ACS between October 2010 and January 2019 were retrospectively identified from a national registry of acute coronary syndromes and were divided in two groups as per anticoagulation strategy (fondaparinux vs enoxaparin). Key exclusion criteria were contraindications to low-molecular-weight-heparins, recent hemorrhagic stroke or indications for anticoagulation other than ACS. The primary efficacy endpoint was a composite of in-hospital reinfarction and mortality, and the primary safety endpoint was a composite of major bleeding, blood transfusion or hemoglobin drop of >3g/dL.</p> <p> </p> <p><strong>Results:</strong> A total of 5843 patients admitted with NSTE-ACS (mean age 65 ± 13 years-old, 72.4% males) were included, of whom 89.2% had non-ST elevation myocardial infarction and 10.8% unstable angina. The most frequent comorbidities were: hypertension (71.3%), dyslipidemia (63.0%) and diabetes (31.7%). Fondaparinux was the anticoagulant of choice in 27.5% of patients while the remainder received enoxaparin. Invasive revascularization was the chosen strategy in 87.7% of the cohort (79.1% in the fondaparinux group vs. 90.9%, p-value <0.001). The primary efficacy and safety endpoints occurred in 2.4% and 4.7% of patients, respectively. Compared to patients receiving enoxaparin, those in the fondaparinux group were younger, had less hypertension or diabetes and had a less severe presentation; nonetheless, they had more often a previous history of coronary artery disease or hemorrhagic events. After adjustment for relevant covariates, the use of fondaparinux was independently associated with lower risk of occurrence of the primary efficacy (OR 0.56 [0.32-0.95], p-value 0.034) and safety endpoints (OR 0.37 [0.23-0.59], p-value < 0.001).</p> <p> </p> <p><strong>Conclusions</strong>: In a Portuguese cohort of NSTE-ACS patients, fondaparinux was independently associated with lower risk of in-hospital reinfarction or mortality and decreased risk of significant hemorrhagic events. Despite the inherent limitations, our findings unveil the underuse of fondaparinux, despite being guidelines-recommended and having a better efficacy-safety profile in our population.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site